| |
277 E Amador Ave Ste 309 Las Cruces NM 88001-3676 | |
(575) 265-0582 | |
(575) 636-2500 |
Full Name | |
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Speciality | Social Worker |
Location | 277 E Amador Ave Ste 309, Las Cruces, New Mexico |
Authorized Official Name and Position | Angelina M. Valdespino (OWNER/CLINICAL DIRECTOR) |
Authorized Official Contact | 5752650582 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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277 E Amador Ave Ste 309 Las Cruces NM 88001-3676 Ph: (575) 265-0582 | 277 E Amador Ave Ste 309 Las Cruces NM 88001-3676 Ph: (575) 265-0582 |
NPI Number | 1801425756 |
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Provider Enumeration Date | 04/03/2020 |
Last Update Date | 01/06/2025 |
Certification Date | 01/06/2025 |
Medicare PECOS PAC ID | 9234532623 |
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Medicare Enrollment ID | O20210722002039 |
Identifier | Type | State | Issuer |
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1801425756 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Angelina M Valdespino |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1568742492 PECOS PAC ID: 5991108714 Enrollment ID: I20210730000958 |
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